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Details of Democratic House Speaker Nancy Pelosi’s closely guarded drug-pricing plan are now out, and she’s not messing around. The draft proposal, outlined in a document first obtained by Bloomberg Government, would give Medicare the power to directly negotiate the price of 250 expensive drugs – focusing mostly on medicines that lack robust competition – and grant the government sharp teeth in those talks. Drug prices would be tied to their average cost in a basket of developed countries that have more affordable medicines, and pharmaceutical companies that refused to negotiate or extend lower prices to other parts of the health system would face significant fines. (Max Nisen, 9/10)

If you take a pill every day to treat high blood pressure or high cholesterol, you probably don’t spend much time thinking about where those drugs come from or what you would do if your pharmacy suddenly couldn’t fill your prescription. But when it comes to the sources of their prescription drugs, what Americans don’t know can hurt them. Most of the drugs Americans take — as much as 90 percent — are generics. But before such drugs arrive at pharmacies in pill form, they start as active pharmaceutical ingredients (APIs). China now dominates that market globally. And though India is a large manufacturer of the finished product along with China, Indian companies get 80 percent of their ingredients from China. (Reps. Anna G. Eshoo and Adam B. Schiff, 9/10)

When Frederick Banting, Charles Best, and James Collip filed for a U.S. patent on insulin in 1923 and sold it to the University of Toronto for $1 each, they did it because, as Best once said, “insulin belongs to the world. ”They also believed that securing the patent was a form of publication, and wrote to the university president, “When the details of the method of preparation are published anyone would be free to prepare the extract, but no one could secure a profitable monopoly. ”Sadly, they were mistaken. (Dana Brown and Elizabeth Pfiester, 9/10)

A targeted bargaining strategy using tried and tested arbitration techniques could help Medicare balance drug innovation and affordability. Such negotiation could lower excessively high prices, even as parts of the market where competition works well are left alone. (Richard G. Frank and Len M. Nichols, 9/4)

As an independent gastroenterologist, I treat thousands of patients in the Washington, D.C., metropolitan area who have gastrointestinal issues. Some of the most challenging cases my colleagues and I confront are for patients who live with Crohn’s disease or ulcerative colitis, which are painful, medically incurable diseases that attack the digestive system. Unfortunately, the Senate is considering a proposal that would make it harder for my patients to afford much-needed medications that improve their quality of life. (Michael Weinstein, 9/11)

My name is Cynthia Stockton. I am a 71-year-old senior living in Sacramento. I have spent a lifetime wearing many hats: self-made college graduate, Army wife and a contributor to the workforce for more than 50 years, including 22 years spent working as a public servant for Sacramento County and 10 years managing senior communities. I had planned to write children’s books and create artwork for friends in my retirement. (Cynthia Stockton, 9/4)